Moving to Recovery - Community Care Behavioral Health

Moving to Recovery

Assumptions…
• This audience
– knows something about recovery principles
and person-centered care
– is interested in moving from theory/values to
practical implementation strategies
– wants to improve their skills

Objectives
• Recovery Principles
• Literature Review
• System Integration
• Practical Tools
• Handout-”Packet of Recovery Materials”

Recovery Principles

Recovery
• The 2005 National Consensus Statement
on Mental Health Recovery from SAMHSA
defines mental health recovery as:
– a journey of healing and transformation
enabling a person with a mental health
problem to live a meaningful life in a
community of his or her choice while striving
to achieve his or her full potential

Recovery - Hope
Recovery provides the essential and motivating
message of a better future— that people can and
do overcome the barriers and obstacles that
confront them. Hope is internalized; but can be
fostered by peers, families, friends, providers, and
others. Hope is the catalyst of the recovery
process. Mental health recovery benefits
individuals with behavioral health disabilities by
focusing on their abilities to live, work, learn, and
fully participate in our society, and enriches the
texture of community life.

Recovery - Self-Direction
Consumers lead, control, exercise choice over,
and determine their own path of recovery by
optimizing autonomy, independence, and control of
resources to achieve a self-determined life. By
definition, the recovery process must be selfdirected
by the individual, who defines his or her
own life goals and designs a unique path towards
those goals.

Recovery - Individualized and
Person-Centered
There are multiple pathways to recovery based on
an individual’s unique strengths and resiliencies
as well as his or her needs, preferences,
experiences (including past trauma), and cultural
background in all of its diverse representations.
Individuals also identify recovery as being an
ongoing journey and an end result as well as an
overall paradigm for achieving wellness and
optimal mental health.

Recovery - Empowerment
Consumers have the authority to choose from a
range of options and to participate in all
decisions—including the allocation of resources—
that will affect their lives, and are educated and
supported in so doing. They have the ability to join
with other consumers to collectively and
effectively speak for themselves about their
needs, wants, desires, and aspirations. Through
empowerment, an individual gains control of his
or her own destiny and influences the
organizational and societal structures in his or her
life.

Recovery - Holistic
Recovery encompasses an individual’s whole life,
including mind, body, spirit, and community.
Recovery embraces all aspects of life, including
housing, employment, education, mental health
and healthcare treatment and services,
complementary and naturalistic services, addictions
treatment, spirituality, creativity, social networks,
community participation, and family supports as
determined by the person. Families, providers,
organizations, systems, communities, and society
play crucial roles in creating and maintaining
meaningful opportunities for consumer access to
these supports.

Recovery - Non-Linear
Recovery is not a step-by step process but one
based on continual growth, occasional setbacks,
and learning from experience. Recovery begins
with an initial stage of awareness in which a
person recognizes that positive change is
possible. This awareness enables the consumer
to move on to fully engage in the work of
recovery.

Recovery - Strengths-Based
Recovery focuses on valuing and building on the
multiple capacities, resiliencies, talents, coping
abilities, and inherent worth of individuals. By
building on these strengths, consumers leave
stymied life roles behind and engage in new life
roles (e.g., partner, caregiver, friend, student,
employee). The process of recovery moves
forward through interaction with others in
supportive, trust-based relationships.

Recovery - Respect
Community, systems, and societal acceptance
and appreciation of consumers —including
protecting their rights and eliminating
discrimination and stigma—are crucial in
achieving recovery. Self-acceptance and
regaining belief in one’s self are particularly vital.
Respect ensures the inclusion and full
participation of consumers in all aspects of their
lives.

Recovery - Responsibility
Consumers have a personal responsibility for
their own self-care and journeys of recovery.
Taking steps towards their goals may require
great courage. Consumers must strive to
understand and give meaning to their
experiences and identify coping strategies and
healing processes to promote their own
wellness.

Recovery - Peer Support
Mutual support—including the sharing of
experiential knowledge and skills and social
learning—plays an invaluable role in recovery.
Consumers encourage and engage other
consumers in recovery and provide each other
with a sense of belonging, supportive
relationships, valued roles, and community.

Community Care’s Recovery Goals
• Transforming the attitudes of all those who are
directly or indirectly involved with the behavioral
health system to believing that recovery is
possible for all, empowerment and integration
for all behavioral health consumers is essential,
and shared decision-making at all levels is key.

Community Care‘s Recovery Goals
• Imparting knowledge to peers and staff regarding
innovative and evidence-based practices to
promote recovery.
• Building the skills of all stakeholders to promote
effective recovery-oriented, consumer-driven
services.

Community Care’s Recovery Focus
• A contract with Pat Deegan, Ph.D. & Associates,
in partnership with Advocates for Human Potential
(AHP).
– To provide consultation and training on their
system-wide effort to implement recoveryoriented
services at all levels of their behavioral
health service system.
• Recovery education and training
• RoadMap to Recovery
• Steps of Recovery
• Conferences

Community Care’s Recovery
Philosophy
Community Care’s recovery philosophy is
grounded in the belief that recovery from mental
illness is not the privilege of a few, but a
possibility for everyone.

Recovery Characteristics
Mental health systems that support recovery
are characterized by:
• Consumer voice and choice.
• Person-centered planning.
• Evidence-based practices.
• A skilled workforce including peer
specialists.

Recovery Characteristics
• Medical staff who are skilled in shared
decision making.
• Community integration outcomes that
include a job, home, transportation, and
discretionary income.

Recovery Learning Community
• Includes web site (www.recoverylearning.com ),
consumer advisory committee, on- and off-site
technical assistance, an annual training institute,
and special project development.
• Uses a high-tech, high-touch approach, to
develop and deliver a shared learning
opportunity, on-site technical assistance and
mentoring, assistance with implementation
efforts, and captures lessons learned.

Substance Abuse Recovery
• People, places,
and things
• Shame
• Self-medication
• Substitute
addictions
• Safety and anxiety
• Relevance of
family and
significant others
• Dual Diagnosis
• Co-Dependence
• Denial
• Spirituality

Substance Abuse Recovery
• Must recognize the inter-relationship of
the:
– Individual
– Environment
– Substance

Substance Use Recovery is About:
• Feelings
• Acceptance
• Growth
• Surrender
• Trust
• Willingness
• Spirituality
• Freedom
• Love
• Life

A Definition of Recovery
• Recovery is a self-determined and holistic
journey that people undertake and grow.
Recovery is facilitated by relationships and
environments that provide hope,
empowerment, choices and opportunities
that promote people reaching their full
potential as individuals and community
members.
-from “A Call for Change: Toward a Recovery-
Oriented Mental Health Service System for Adults”

Mental Health Recovery
• Must recognize the inter-relationship of
the:
– Individual
– Environment
– Diagnosis

Influences on Recovery
• Degree of illness experienced.
• +/- impact and/or intervention of others
including the Behavioral Health system.
• Interaction with and/or reactions to:
– hospitalizations
– medications
– incarceration
– interpersonal relations

Key Areas of Concern
• Access to good clinical healthcare.
• Identifying and developing supportive
relationships.
• Determining and accessing meaningful
activity.
• Gaining personal power and control over
life.
• Overcoming stigma.

Key Points of Recovery
• Developing strong relationships with
caring, encouraging, hopeful people.
• Self-determination.
• Self-monitoring and self-management.
• Vocational activity and schooling.

Key Points (cont’d)
• Developing a sense of meaning and
purpose.
• Knowledge and acceptance.
• Self-help and peer support.

Partners in Recovery
• Consumer
– Depends upon the clinician, family, and
community to provide the best possible
services.
• Clinician
• Family and community
– Supports in an anti-stigma environment
– Housing, employment, peer support
– Funding

Role of Clinical Care
• Traditionally focus was on illness and
symptoms.
• Recovery embraces the individual’s
strengths and focuses on wellness.
• Individual is a partner, another expert.
• Clinician works side by side with consumer
to display respect.

Consumer Choice
• Consumers must know and understand
that they are entitled to make choices
regarding behavioral health services and
supports they receive.

The Road to Recovery
• Consumer directed
• Strengths based
• Culturally competent
• Utilizes community/natural supports

Best Practice Principles
• The consumer directs the recovery process
and is an essential part of the team.
• Individual differences are considered and
valued.
• A holistic approach is utilized:
– Medical, Psychological, Social, and Recovery
intervention models are merged.

Best Practice Principles (cont’d)
• Strengths and assets are identified and
emphasized.
• A collaborative recovery management plan
is developed.
• Families, as defined by the consumer, are
involved.
• Services are within the consumer’s
community.

Outcomes of Recovery
• Increased Motivation
• Increased Self-Esteem
• Feeling a part of instead of isolated from
• Self respect
• Desire to help others
• Hope instead of despair

Outcomes of Recovery (cont’d)
• Optimal functioning
• To live in the community
• To participate in the lifestyle of the
individual’s choice

Literature Review

Literature Review
• Courtney Harding, PhD
• Patricia Deegan, PhD
• Daniel Fisher, MD, PhD
• Mary Ellen Copeland, MS, MA
• Priscilla Ridgway, PhD
• LeRoy Spaniol, PhD
• William White, MA

Courtney Harding, PhD
• Longitudinal research with individuals diagnosed
with Schizophrenia.
• People with mental illness can and do recover.
– Looked at a period of 20-30 yrs.
Empirical Correction of Seven Myths About Schizophrenia with Implications for
Treatment, by Courtenay M. Harding, Ph.D., and James H. Zahniser, ACTA
Psyciatrica Scandinava, 1994: 90 (suppl 384): 140-146.
The Vermont Longitudinal Study of Persons With Severe Mental Illness, II: Long-
Term Outcomes of Subjects Who Retrospectively Met DSM-III Criteria for
Schizophrenia, by Courtenay M. Harding, Ph.D., George W. Brooks, M.D.,
Takamaru Ashikaga, Ph.D., John S. Strauss, M.D., and Alan Breier, M.D.,
American Journal of Psychiatry 144:6, June 1987.

Patricia Deegan, PhD
• Multiple publications and research projects
• Tools
– Individual
– System
• Common Ground
• Shared decision making
• Decisional uncertainty
• Hearing Voices
http://www.patdeegan.com/

Daniel Fisher, MD, PhD
• Psychiatrist diagnosed with Schizophrenia.
• Focuses on medication issues.
• Established the National Empowerment
Center.
http://www.power2u.org/who.html

Mary Ellen Copeland, MS, MA
• Motivational speaker, and recovery
educator.
• Emphasizes “wellness”
• Has designed WRAP plan
– Utilizes a “train the trainer” model.
http://www.mentalhealthrecovery.com/

Priscilla Ridgway, PhD
• Research and materials development
– Consumer Workbook-
• Can be used independently of the therapist or as
a supplement to treatment.
• Takes a strengths based approach to
recovery, using incremental steps.
• Has developed evaluation tools for
systems
– ROSI, REE, ERFS
http://www.yale.edu/PRCH/people/PriscillaRidgwayPh.D..html

LeRroy Spaniol, PhD
• Created workbooks for recovery.
• Designed for therapists to utilize with
consumers.
• Culturally competent Spanish version.
http://search.bu.edu/searchq=spaniol&Submit=Search&site=default_collection
&output=xml_no_dtd&client=default_frontend&sort=date%3AD%3AL%3Ad1&proxyst
ylesheet=default_frontend&oe=UTF-8

William White, MA
• Substance use recovery relationship to
behavioral health recovery.
• Extensive writings and material
development.
http://www.facesandvoicesofrecovery.org/resources/publications_white.php

IRETA
• Recovery materials
– Includes co-occurring information
• Theory and application
http://www.ireta.org/

Systems Materials
• Connecticut
• Ohio
• Georgia
• Illinois
www.ct.gov/dmhas/lib/dmhas/publications/practiceguidelines.pdf
http://www.mhrecovery.com/best_practices.htm
http://www.mentalhealthworld.org/48GCPSP.htm
http://www.illinoismentalhealthcollaborative.com/consumers/consumer_resources.htm
• Alaska
http://akmhcweb.org/
• Pennsylvania http://www.parecovery.org/principles_change.shtml
• New York
www.carecoordination.org/video_guide.pdf

System Change

Transformation
• A break with the past
• Quantum change
• More than just reorganizing
–new mission and vision for the organization
• Transformation virtually always refers to a
positive change
– a movement to a new venture
• A radical redesign and new strategic intent
for the organization

Transformation Principles
• Services and treatments must be consumer and
family centered, geared to give individuals real
and meaningful choices about treatment options
and providers – not oriented to the requirements
of bureaucracies
• Care must focus on increasing a person’s ability
to successfully cope with life’s challenges, on
facilitating recovery, and on building resilience,
not just on managing symptoms
President’s New Freedom Commission on Mental Health

Goal of Recovery Transformation
The goal of recovery is:
• To move from a state of
dependency to
interdependency
•To have all aspects of
society and organizations
utilizing recovery
principles

Setting the Compass
Experience of Individuals,
Families and Communities
Microsystems of
Care
Where care occurs
Health Care
Organizations
External Environment of Care
Policy/Financing/Regulation

Change Model
Competency
knowledge, skills and abilities
Change
Management
behavior and
attitude
Project
Management
work / business
flow

Competencies
• Providers should be able to
– understand the concepts of recovery,
resilience, wellness, person-centered and
culturally competent approaches
– understand and value the centrality of the
individual planning process as a roadmap to
recovery and wellness
– understand how emerging new frameworks
differ from past and current practice
– identify the elements of a plan and the criteria
for each element

Competencies
• Providers should be able to
– understand the concept of medical necessity
and key elements of documentation
– conduct a strengths based person-centered
and culturally competent assessment
– create a formulation or integrated summary
based upon the assessment
– evaluate the individual’s/families stage of
change to inform and guide the planning
process
– help individuals/families articulate personcentered
goals and discharge/transition needs

Competencies
• Providers should be able to
– help individuals/families articulate
person-centered goals and
discharge/transition needs
– identify barriers and establish priorities to
attaining the goal's
– elaborate objectives to resolve barriers in
partnership with the person and family served
– build on strengths, choices, preferences and
stage of change to recommend interventions,
services, supports and other strategies to
promote positive change

Competencies
• Providers should be able to
– specify a broad range of
culturally-competent stage
appropriate supports / services
– accept the individuals’ / families’ dignity, ability
to take risk and “right to fail”
– facilitate/monitor/coordinate plan
implementation
– provide timely update of assessment and plan
– properly document plan elements and services
– participate in an ongoing quality management
process with outcome data

12 Aspects of Staff Transformation
1. Looking forward and rebuilding the passion
2. Building inspiration and belief in recovery
3. Changing from treating illness to helping people
with illnesses have better lives
4. Moving from caretaking to empowering, sharing
power and control
5. Gaining comfort with mentally ill co-staff and
multiple roles
6. Valuing the subjective experience
Mark Ragins, MD

Staff Transformation con’t
7. Creating therapeutic relationships
8. Lowering emotional walls and becoming a
guiding partner
9. Understanding the process of recovery
10.Becoming involved in the community
11.Reaching out to the rejected
12.Living recovery values
Mark Ragins, MD

Guideline Categories
• Administration
• Treatment
• Supports

Mission and Vision
• Development of mission and vision
statements articulating organizational
commitment to recovery and a process for
achieving recovery oriented services.
• Organizational review and strategic
planning process that incorporates diverse
viewpoints from the community of service
users.

Organizational Structure
• Annual budget insures adequate
resources to support consumer
participation in administrative processes.
• Significant representation of persons in
recovery on organization’s treatment and
support staff.

Training and Continuing Education
• Processes developed for interactions
and/or communications between
consumer and providers in non-clinical
settings.
• Establishment of core competency
standards regarding knowledge of
recovery principles for all staff.

Continuous Quality Improvement
• Processes in place to ensure that
consumers are included in CQI activities
as equal partners with professionals.
• Agency budgets will reflect compensation
for consumer involvement in CQI activities.

Outcome Assessment
• Outcome indicators will include items
related to quality of life, recovery and self
fulfilling function.
• Established process for consumer
participation in developing outcome
indicators for progress in recovery.

Service Arrays
• Integration of consumer, family and peer
supports, disease management education
and crisis management planning will be
reflected in policy and procedure
documents.
• Establishment of services supportive of
recovery processes and which incorporate
self management principles.

Drowning in Help #1

Drowning in Help #2

Drowning in Help #3

The Moral of the Story
• There may be too many reports on drowning
and not enough life preservers.
• Help isn’t help if it’s not helpful to the person
receiving services. It can be toxic help.
• Help is always co-created between the
professional and client.
• Recovery is a self-directed process of healing
and transformation that can be supported by the
professional, peers, family and the community.

Transformation
T =
V = vision
B = beliefs
A = action
(V + B + A) x (CQI) 2
Resistance
to change
CQI = continuous quality improvement

Transformation Principles
• Develop relationships with people, not
disorders.
• Nothing about us without us!
• Practice respect.
• Recovery is real!
• Recovery is hard work!
• Recovery is universal.
• Recovery includes the whole community.

Affirmation
Everybody is Somebody
Nobody is a Waste of My Time

Access

What’s In A Word
• Clinical language can be disrespectful
– Crazy
– Honey
– You’re doing well for a schizophrenic
– She is such a borderline
– He is decompensating
– She is low functioning/high functioning
– He’s a harmless burnt out schizophrenic

People With Psychiatric Disabilities are
Resilient
I Am Not The
Problem!
I Am Part of the
Solution

Affirmation
Recovery means
changing our lives,
not our
biochemistry

Nuts and Bolts

A Definition of Recovery
• Recovery is a self-determined and holistic
journey that people undertake and grow.
Recovery is facilitated by relationships and
environments that provide hope,
empowerment, choices and opportunities
that promote people reaching their full
potential as individuals and community
members.
-from “A Call for Change: Toward a Recovery-Oriented
Mental Health Service System for Adults”

Recovery is Being Person-centered
in Practice
• The consumer as a whole person
• Sharing power and responsibility
• Having a therapeutic alliance
• The clinician as a person
• Language choices

“If you don’t know where you are
going, you will probably end up
somewhere else.”
Lawrence J. Peter

Planning Processes
• Development of collaborative process for
developing continuous comprehensive
service plans between consumers and
providers.
• Process in place to inform consumers of
treatment/service options and to discuss
pros and cons of each prior to service plan
development.

A Plan is a Road Map
Provides hope by breaking a seemingly
overwhelming journey into manageable steps for
both the provider and the person served.
B C D
A
E
“life is a journey…not a destination”

Building a Plan
Outcomes
Services
Objectives
Strengths/Barriers
Goals
Prioritization
Understanding
Assessment
Request for services

Goals
• Three types
– life goals
– treatment goals
– quality of life / enhancement goals
• Essential features
– Attainable, realistic, written in positive terms
• built upon abilities / strengths, preferences and
needs
• embody hope
• alternative to current circumstances

Barriers
• What keeps a person from
their goals
– Intrusive or burdensome
symptoms
• Challenges or needs as a result of a co-occurring
disorder
– Lack of resources
– Need for assistance, supports, skills
development
– Housing, employment
– Lack of relationships or meaningful activity

Strengths
• Environmental factors that will increase
the likelihood of success:
– community supports, family/relationship,
support/involvement, work
• Competencies/accomplishments
• Past successful strategies
• Motivation, interests and activities
• Services are not an objective

Stages of Change and Recovery
• Prochaska and DiClemente
• Ohio Department of MH
• The Village—LA County MHA
• Stanislaus County
• Boston University Center for Psychiatric
Rehabilitation Center
• AACP / LOCUS

Stages of Recovery and Treatment
Ohio
Village
Prochaska &
DiClemente
Stage of
Treatment
Treatment Focus
Dependent
unaware
High risk/
Unidentified or
Unengaged
Precontemplation
Engagement
• outreach
• practical help
• crisis intervention
• relationship
building
Dependent
aware
Poorly
coping/Engaged
/not self-directed
Contemplation
/preparation
Persuasion
• psycho-education
• set goals
• build awareness
Independent
aware
Coping/Self
responsible
Action
Active
Treatment
• counseling
• skills training
• self-help groups
Interdependent
aware
Graduated or
Discharged
Maintenance
Relapse
Prevention
• prevention plan
• skills training
• expand recovery

Dependent
Unaware
Dependent
Aware
Independent
Aware
Interdependent
Aware

Meeting client where they’re at…
ADDICTION RECOVERY
Prevention
Early
Intervention
Pre
Contemplation
Contemplation Action Relapse
Prevention
Sustained
Recovery
Each person is able to utilize interventions
responsive to their stage of change
Prevention
Early Identification
and Intervention
Pre-
Contemplation
Contemplation
Engaged in Active
Treatment and Rehab
Self
Care
MENTAL HEALTH RECOVERY

Another view of recovery stages…
Impact of the
illness
Life is
limited
Change is
possible
Commitment
to change
Actions for
change
Overwhelmed
Not ready to
commit to
change
Believes there
is more to life
Willing to
explore
possibilities
Taking
responsibility
for a new
direction
derived from BU Center for Psych Rehab

as suggested by
Ed Knight
overwhelmed
by…
The person is…
moving
beyond…
…the
disabling
power of
the
illness
challenging…
questioning…
giving in
to…

Integration of Addiction and Mental
Health Recovery
• Establishment of recovery principles as
unifying concepts in provision of holistic
mental health, physical health and
addiction services.
• The presence of co-occurring substance
and mental health disorders is reliably
detected through screening processes.

Advance Directives
• Established process for obtaining informed
advance directives from consumers during
periods of relatively healthy function.
• Established process for review of advance
directives during periods of
relapse/incapacitation.

Coercive Treatment
• Development of strategies to engage and
empower clients on involuntary status that
are incorporated into treatment plans and
agency programming.
• Demonstration of reduction in the use of
coerced treatment options over defined
periods.

Advocacy and Mutual Support
• Active facilitation of participation of clients
in advocacy organizations is
demonstrated.
• An agency liaison with local advocacy and
support groups is identified and active.

Access Facilitating Processes
• Completion of access analysis identifying
systemic barriers to receiving services.
• Service users report satisfaction with their
access to services they have chosen.

Family Services
• Family involvement in agencies will be
reflected in educational, social and
advocacy programming by the agency.
• Liaison and collaboration with advocacy
groups will be reflected in family oriented
programming.

Employment and Education
• Development of an array of employment
and training opportunities with various
levels of support.
• Process for vocational counseling and
support is integrated with other aspects of
the recovery process.

Housing
• Consumers feel that their housing choices
are respected to the greatest extent
possible.
• A wide array of housing options and
available, including various tolerant
housing options.

Medication
• Medication is not just an MD thing.
• What is individual’s role
• Decisional uncertainty.
• Education.

Principles
• Use in Conjunction with Psycho-social
Approaches.
• Simplicity.
• Timing.
• Target Symptoms/Diagnostic Clarity
(substance induced vs real).
• Understand consumer's perspective.
• Emotional climate.

Community Care RoadMAP Project
• Medication algorithm specific to schizophrenia,
consumer portion applicable to all illnesses.
• Educational support to physicians, consumers,
families.
• Four Allegheny County agencies provide at 7
sites.
• RoadMAP facilitators and Community Care meet
on a regular basis.
• Facilitator trainings scheduled in October for two
agencies in both Berks and Chester Counties.

RoadMAP to Recovery
• A quality improvement initiative designed
to involve consumers, practitioners, family
members and supporters in a unified effort
to practice evidence-based medication
prescribing to promote optimal consumer
recovery.

SAMHSA Evidence Based
Practices
• Illness Management and Recovery.
• Assertive Community Treatment.
• Family Psychoeducation.
• Supported Employment.
• Integrated Dual Diagnosis Treatment.
• http://mentalhealth.samhsa.gov/cmhs/communitys
upport/toolkits/about.asp

Effective Use of Resources
• Progressive Continuums.
• Overlapping and Integrated Levels of
Resource Intensity.
• Linking Phases of Treatment.
• Quality Processes to Enhance Utilization.

Comprehensiveness
• Includes an array of arrangements
sufficient to meet all identified needs.
• Case management, child care, residential
support, financial assistance, mutual
support, etc.

Coordination and Integration
• Concurrent involvement of agencies on
both sides of the transition occurs.
• Information sharing.
• System creates rational incentives for
coordination.

Continuity in Planning
• Building on established treatment plans
when successful.
• Plan is continuous across entire episode
of illness/disability.
• Regional standardization of planning
formats.

Support System Involvement
• Family and other significant members of
support system, as identified by service
user, to be included in planning process.
• Significant efforts to enlist participation are
documented .

Cultural Sensitivity
• Recognition of individual’s beliefs,
customs, and social context in planning
process.
• Transition plan reflects these cultural
considerations.

Prevention
• Relapse prevention, using historical
context for episodes of illness,
incorporated into the plan.
• Appropriate use of community resources.

Resource Access
• Maximize access to available resources.
• Encourage autonomy and recovery in
obtaining necessary resources.

Community Care Initiatives
• CTT.
• RoadMAP.
• Collaboration with ACCR.
• Recovery Conferences.
• Recovery Institutes.

Collaboration: Allegheny County of
Coalition for Recovery
• Group of consumers, families, agency and
county representatives, and other stakeholders.
• Resilience and children/youth statements.
• Universality statement.
• Social Marketing Campaign.
• Booklet development.
• Dialogues.
• Development of community partnerships.

Success is not final, failure is not
fatal: it is the courage to continue
that counts.
Winston Churchill

Concluding Thoughts
(How Does Each Of Us)
Become the change that we want to see in the
world.
Mohandas Gandi
(Can we become)
A small group of thoughtful people can change the
world. Indeed, it's the only thing that ever has.
Margaret Mead
…